Acceptability and feasibility of a mobile health intervention to support patients with chronic pain during opioid tapering: a pilot randomised controlled trial

Abstract

Background: Opioids are no longer recommended as long-term therapy for chronic noncancer pain (CNCP). Patients are advised to reduce/discontinue opioids when the risks outweigh the benefits. Patients report difficulties in tapering, necessitating the development of, and access to, supporting interventions.

Aims: To develop and evaluate the acceptability, feasibility, and efficacy of a mobile health intervention to support patients with CNCP during opioid tapering.

Methods: A mobile health intervention, consisting of a psychoeducational video and a library of text messages, was co-produced by patients, clinicians, and researchers and was evaluated by consumers and clinicians panels. After revisions, a pilot randomised controlled trial was conducted to test the acceptability, feasibility, and potential efficacy of the intervention. Patients with CNCP who were tapering opioids were randomised to receive the intervention in addition to the usual care for 4 weeks. Acceptability, feasibility, and potential efficacy were assessed.

Results: To date (12 months into recruitment), 38 patients have been screened, 26 met the eligibility criteria and were randomised. Feedback surveys indicate the acceptability of the intervention (e.g., useful 70%, supportive 80%, recommending to others 90%). Most participants suggested a longer intervention period. Recruitment is still open and potential efficacy data will be presented at the meeting.

Conclusions: It is feasible and acceptable to support patients during opioid tapering with text messaging interventions that are co-designed. Most patients wish for support for longer than 4 weeks, hence, a definitive trial with large sample size (national level) is initiated to test the efficacy of a 12-week intervention.